A nurse is preparing to feed a newly admitted client who has dysphagia. Which of the following actions should the nurse plan to take?

Rationale:

A. Explain the cast application procedure to the child: Preparing the child for a future procedure is helpful but not immediately necessary. At this point, pain control and reduction of swelling take precedence to prevent complications and stabilize the injury.

B. Review cast care instructions with the child's parents: While parent education is important, it is secondary to immediate interventions that address pain, swelling, and preparation for the procedure. Priority actions focus first on the child’s current needs and safety.

C. Elevate the affected forearm with pillows: Elevation helps reduce edema and pain in the fractured extremity and prevents further swelling. This is a critical nursing intervention for acute fracture management before and after casting.

D. Apply ice packs to the fingers and along the right forearm: Ice helps manage pain and inflammation by vasoconstriction, limiting fluid accumulation in tissues. Applying it early post-injury is crucial to controlling swelling in a fractured limb.

E. Place a nonadherent dressing on the right knee abrasion: Caring for minor abrasions is important but is not a priority compared with interventions addressing fracture management, pain, and preparation for cast application.

F. Administer Ibuprofen 200 mg PO: Pain management is a priority in fracture care to maintain comfort and reduce distress. Administering analgesics before cast application helps the child tolerate the procedure and facilitates cooperation.

Rationale:

A. Compare the current infusion with the prescription in the client's medication record: The first action is to verify the actual prescription against the current IV infusion. This ensures that the client is receiving the correct medication, dose, and rate, and allows the nurse to identify any errors or discrepancies before taking further action.

B. Submit a written warning for the nurse involved in the incident: Disciplinary action is not appropriate as an initial step. The priority is client safety and verifying facts, not assigning blame. Investigations or corrective actions follow after assessment and verification.

C. Complete an incident report and place it in the client's medical record: Incident reports are used to document discrepancies or errors, but they should not be placed in the medical record. They are submitted to risk management or quality assurance separately. Filing in the medical record could create legal and confidentiality issues.

D. Contact the charge nurse to see if the prescription was changed: While notifying the charge nurse may be necessary, it should occur after verifying the prescription and confirming the discrepancy. Immediate assessment and comparison to the medication record take priority to ensure client safety.